Abstract
Sentinel node biopsy has been established for several years now as a standard procedure of breast cancer surgery, but there are several variations of the indications and the technique used. This paper provides information regarding several issues of debate for its application as are the selection criteria, the application to patients with multifocal/multicentric breast cancer or DCIS, postneoadjuvant chemotherapy, the necessary number of nodes to be biopsied, the need for lymphoscintigraphy, the technique for frozen section, the factors that may predict nonsentinel nodes (NSNs) involvement, the value of micrometastasis and isolated tumour cells, the internal mammary chain sentinel nodes, and finally the axillary recurrence after SLNB. Our view for these issues is included together with our experience of 430 SLNBs.
Highlights
Lymph node status is a key factor in determining the stage of breast cancer and the most appropriate therapy and for predicting the outcome of patients
It is still controversial whether SLNB is acceptable for patients with clinically positive nodes at initial diagnosis who are treated with neoadjuvant chemotherapy, whereas SLNB alone is acceptable for patients with an initial diagnosis of clinically negative axilla who are treated with neoadjuvant chemotherapy
Axillary ultrasound with FNA or core biopsy is accepted as helpful, because of its high specificity, in order to decrease the number of SLNBs
Summary
Lymph node status is a key factor in determining the stage of breast cancer and the most appropriate therapy and for predicting the outcome of patients. Accurate identification of sentinel lymph nodes (SLNs) preoperatively is of clinical importance. The results of the NSABP B-32 study indicate the superiority of the SLNB compared to the ALND treatment approach relative to postsurgical morbidity outcomes over a 3-year follow-up period [1]. The use of ipsilateral upper arm is not restricted if only SLNB is applied. In the sentinel lymph node (SLN) era, axillary lymph node dissection (ALND) for uninvolved axillary lymph nodes should be considered unnecessary and inappropriate. The sentinel lymph node biopsy sensitivity is more than 90%, its specificity 100%, its accuracy more than 95%, and the axillary recurrence rate is less than 1%. There are still though some disputable issues on this subject
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
